Hepatic Insufficiency: Medical History

Medical history (history of illness) represents an important component in the diagnosis of liver failure. Family history

  • Is there a history of frequent liver disease in your family?

Social history

Current medical history/systemic history (somatic and psychological complaints).

  • Do you suffer from any brain dysfunction?
    • Disturbance of consciousness*
    • Euphoria, depression*
    • Insomnia (sleep disorders)
    • Confusion*
  • Have you noticed yellowing of the skin and/or eyes?
  • Have you or anyone else noticed that your breath smells like raw liver?
  • Do you have a coarse hand tremor?
  • Have you noticed bleeding disorders, i.e. prolonged bleeding from wounds?
  • Do you suffer from abdominal dropsy? (abdominal girth increase due tofluid accumulation in the free abdominal cavity)* .
  • Do you suffer recently increased low blood pressure (eg, dizziness, tendency to collapse, fatigue, cold hands, etc.).
  • Have you noticed that you have excessive breathing?

Vegetative history including nutritional history.

  • Have you recently consumed mushrooms or similar?
  • Have you been abroad recently?
  • Have/had unprotected sexual intercourse?
  • Do you smoke? If yes, how many cigarettes, cigars, or pipes per day?
  • Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
  • Do you use drugs? If yes, what drugs (ecstasy, cocaine) and how often per day or per week?

Self history incl. drug history.

  • Pre-existing conditions (liver disease, infections, metabolic diseases).
  • Operations
  • Allergies
  • Pregnancy history (HELLP syndrome (H = hemolysis/dissolution of erythrocytes (red blood cells) in the blood), EL = elevated liver enzymes, LP = low platelets)?)
  • Environmental history
    • Tuber leaf fungus intoxication (amanitins).
    • Carbon tetrachloride

Medication history

Researchers at the University of Iceland in Reykjavik had analyzed all cases of drug-induced liver injury over two years in their study. They found that, on average, 19 out of every 100,000 residents suffered liver damage from medications each year. The drugs that frequently affected the liver included paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs), as well as antibiotics. For example, the combination of amoxicillin and clavulanic acid was responsible for 22% of damage

Environmental exposures – intoxications

  • Tuber leaf fungus intoxication (amanitins).
  • Carbon tetrachloride

* If this question has been answered with “Yes”, an immediate visit to the doctor is required!(data without guarantee)